Anticoagulation agents

New Therapeutic Anticoagulant Agents. There ate some patients who cannot receive heparin or warfaria but who aeed anticoagulatioa. To deal with this aeed, appreciable iavestigatioa is ia progress to ideatify aew anticoagulants. Several such agents ate on the horizon. 

Anticoagulant therapy was developed with the adventitious discovery of dicoumarol (8). A fuller discussion of the rationale for the use of such compounds is found in the chapter on Five-Mem-bered Heterocycles Fused to One Benzene Ring. The reader s attention is directed, however, at the fact that dicoumarol is a polycarbonyl compound containing a very acidic hydrogen. A series of similarly acidic 1,3-indandiones have been found to constitute an additional class of anticoagulant agents. 

Markwardt F. Hirudin and derivatives as anticoagulant agents, Thromb Haemost 1991 66, 141-52. 

In practice, some anticoagulation agents such as heparin or antiplatelet agents, e.g. nitric oxide (NO) are delivered to sensor sites in order to reduce the risk of thrombus formation. Nitric oxide (NO), which is a potent inhibitor of platelet adhesion and activation as well as a promoter of wound healing in tissue, has been incorporated in various polymer metrics including PVC (poly(vinyl-chloride)), PDMS (poly-dimethyl-siloxane) and PU (poly-urethanes). Those NO release polymers have been tested in animals as outer protection coatings and have shown promising effects for the analytical response characteristics of the sensor devices [137],... 

Warfarin is an oral anticoagulant agent available as 1 mg (brown tablets), 3 mg (blue tablets) and 5 mg (pink tablets). The main side-effect of warfarin is increased bleeding. The approximate price of warfarin per tablet is 0.014 ( 0.013). 

Oral anticoagulant agents The concomitant use of argatroban and warfarin has resulted in prolongation of the PT and INR. 

Fitzgerald, G. (1996). The human pharmacology of thrombin inhibition. Coronary Artery Dis. 7(12), 911-918. Markwardt, F. (1991). Hirudin and its derivatives as anticoagulant agents. Thromb. Haemost. 66, 141-152. 

Crowther MA, Warkentin Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy Focus on new anticoagulant agents. Blood 2008 111 4871. [PMID 18309033]... 

Assay of the PABA standard individually in the presence of each plasma sample is necessary (Table 3.7.1 tubes 7 and 8) since some heparin-based anticoagulating agents sometimes used to prepare plasma may diminish the colour development, thus reducing the intensity of the colour. Falsely low activities would be measured in such a sample if the standard factor required to convert the absorbance units to nanomoles (see Calculation below), is determined in the absence of the plasma. 

The relationship between the quantity of serum albumin and activity is, however, not clear. Although it forms up to 50% of the serum proteins in tunas, 40% in horse-mackerel, 14% in scorpion fish and 5% in gobies (Shulman and Kulikova, 1966), such a relationship is not distinct in other orders of fish. In the blood it performs transport functions and is an anticoagulating agent. 

Cheneau E, Canos D, Kuchulakanti PK, et al, Value of monitoring activated clotting time when bivalirudin is used as the sole anticoagulation agent for percutaneous coronary intervention, AmJ Cardiol 2004 94 789-792,... 

Katzen BT Ardid Ml, MacLean AA, et al. Bivalirudin as an anticoagulation agent safety and efficacy in peripheral interventions, J Vase Interv Radiol 2005 16(9) 1183-1187 quiz 7. 

M. Shanmugam and K. H. Mody, Heparinoid-active sulfated polysaccharides from marine algae as potential blood anticoagulant agents, Curr. Sci., 79 (2000) 1672-1683. 

Patients should also be questioned about the use of any medications that might impair clotting. These might include prescription medications such as warfarin or over-the-counter medications such as aspirin. Even dietary supplements such as ginkgo biloba may have potential impact on bleeding. Consultation with the patient s physician is necessary to approve discontinuation of any prescribed anticoagulation agent. 

O Donnell D. Antibiotic-induced potentiation of oral anticoagulant agents. Med J Aust 1989 150(3) 163. ... 

Samama MM, Gerotziafas GT, Elalamy 1, Horellou MH, Conard J. Biochemistry and chnical pharmacology of new anticoagulant agents. Pathophysiol Haemost Thromb 2002 32(5-6) 218-24. 

Table 10. Anti-Parkinson agents. Table 11. Antipsychotic agents. Table 12. Corticosteroid agents. Table 13. Anticoagulant agents.

Acquit coagulation defects are more common, and may be due to liver disease (since bile is required for absorption of vitamin K), dietary deficiency of vitamin K, or ingesUon of oral anticoagulant agents. Most of these can be treated by giving vitamin K and its congeners, menadiol sodium phosphate or phytomenadione. 

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